Ten top tips for preparing for your CQC inspection

Every English practice will be subject to routine inspections by the CQC after registration starts from 1 April, and inspections will then take place every two years – or more frequently, if there are particular issues or problems identified.

The CQC has promised that 48 hours notice will normally be given of the inspection date, although that is hardly long enough to make much of a difference. If they feel that it may be necessary, the CQC also has the right to make unannounced inspections as well at any time. So it will pay dividends always to be prepared for the inspector to call.

The following tips should help you prepare for CQC inspections, and each one explains a suggested ‘action plan’ of a practical activity you can do for tips you find helpful.

1 Prepare the evidence to demonstrate that that you are meeting standards

Don’t try and sweep difficult areas under the carpet. Think through what information you already have (e.g. QOF performance statistics, policies, training records, copies of staff qualifications) to make sure that you have evidence to demonstrate how the practice is meeting each of the essential standards.

Action plan: Develop up-to-date action plans in place for any areas of difficulty – even if it will take some little time to achieve the desired improvements.

2 Anticipate the issues that the CQC inspector is likely to be concentrating on

These can be expected to include aspects such as infection control, safeguarding and CRB/DBS checks, patient engagement, staff recruitment, premises, record keeping systems, confidentiality, equipment and patient safety in the practice.

Action plan: Get some local intelligence from neighbouring practices about the topics which cropped up during their inspection.

3 Check all your staff understand the role of the CQC

Train your staff about the CQC, so that they understand what it is and how it works. Don’t forget that the inspector may ask to talk to anyone working in the practice. In particular, fully brief the Partners. They are all legally responsible for their CQC obligations, so it is essential that know about the CQC’s essential standards and what the practice is doing to meet them.

Action plan: Schedule a whole-practice meeting to inform staff about the CQC, check staff know where to find all policies and whether they know what steps you’re planning to take to meet Essential Standards.

4 Don’t overthink it

Don’t lay out the red carpet – the CQC will want to see the practice ‘as it is’. And don’t focus just on your written policies and procedures – the inspector will be mainly looking for what happens in practice, whether systems work, whether staff are trained, etc.

Action plan: Arrange a mock inspection – and help relieve anxiety by having a partnership-level meeting to discuss its results. This means you can be frank, and decide jointly on your priorities for the future.

5 Think through the implications of your CQC inspection report being publicly available

Agree who can handle any media enquiries, prepare a press statement to respond to any problems highlighted and use your practice website to explain what is planned to respond to the inspection, for example. If you have a chance to comment on the draft inspection report (e.g. to make any corrections to error of fact), make sure that you do this within the timescale allowed.

Action plan: See if the LMC will offer to advise you on any problems that might arise here.

6 Assess the risks that your services present to patients, as well as the risk of not meeting the CQC standards

Remember, that’s what the inspection is all about. It is not just an opportunity for some external bureaucrats to try and catch you out! Inspectors will be looking at aspects such as:

- confidentiality

- breaches of Health and Safety regulations

- how the telephone is answered

- information for patients

- how staff speak to people

- whether full explanations about care are given

- whether chaperones are offered when appropriate.

Action plan: Get ideas for improvements from all your staff, and include these as part of next year’s appraisal for all staff.

7 Anticipate that the inspector may wish to see a sample of patient records

For example, to check on their format and completeness. The general rule is that the name of the patient should be anonymised, although the CQC do have powers to see individual patient records for which generally prior written consent will need to have been given by the patient.

Action plan: Inform patients this may happen, and reassure them that information will be kept confidential.

8 Check your paperwork is up to date

You should check paperwork is up to date, especially your ‘statement of purpose’ - this needs to changed with 28 days of any changes that take place in the practice (such as new services, changes of staff, or partner retirements) Make sure that your staff know where they can access key information such as telephone numbers of the local Child Protection service for referrals, up-to-date copies of the practice’s policies and procedures.

Action plan: Make full use of the practice intranet, as well as having hard-copies of all such information readily available in just one place.

9 Tell your patients they might be interviewed by an inspector

The CQC inspector will wish to talk to patients so alert your patients about the role of CQC, how it works, and the fact inspections are held periodically.

Action plan: Mention the CQC in your practice leaflet and website if possible.

10 Deal with your anxiety before the inspector arrives

If you treat the CQC with respect, this is likely to be reciprocated. Don’t be defensive: the inspection can offer an opportunity for a fresh look at how the practice is providing services for its patients. If you can demonstrate that you are a learning organisation which is already looking to improve? – you’ll be 90% of the way to a successful outcome of your CQC inspection. And if they arrive on an inconvenient day? – that’s likely to be tough-luck.

Action plan: Much of your work is done as a practice team - so prepare for the CQC as a team-effort. If you need to let off steam about the CQC, find a third-party to listen rather than taking it out on the inspector.

Richard Banyard is thedirector of CQCassist Ltd, a specialist support service for CQC registration

I wonder how others deal with the fact that although some GP partners are legally responsible for the CQC compliance of the practice, some key members of the team who must assist with this achievement cannot or do not wish to pull their weight for this common goal? It is extremely unfair to expect that a few give a lot of their own unpaid time for the CQC work only to get a bad CQC report in the end because the rest of the team did not engage enough.

The CQC are big on the use of 'Experts By Experience'. Us your local patients knowledge to its best advantage and gather some evidence from them prior to the CQC visit. Demonstrate that you are listening to your patients (Experts By Experience) by putting and action plan together based upon what they say and report to you.

A point well made – remember that it is the LEGAL ENTITY that is being inspected and registered (e.g. the Practice Partnership) by the CQC. The whole organisation is thus jointly and severely liable, and so everyone needs to be involved and as a minimum understand the issues, potential problem areas with compliance against the CQC standards, etc. This cannot just be left to the Registered Manager and/or Practice Manager.•

Response to Anonymous | 01 April 2013 8:42pm

A wise comment – not least since the CQC are at present placing great emphasis on ensuring that its registered organisations are engaging their clients/patients. Indeed, the first of the 28 CQC standards is all about this! So make sure that you keep all the relevant evidence about this topic – such as the results of your patient surveys, minutes of your patient representative group meetings, details of suggestions made by patients and actions taken as a result, etc. Also, make sure that your material for patients (such as your Practice Leaflet) and your CQC Statement Of Purpose are all kept up-to-date since it is likely that the CQC inspector will ask to see these.

I attended a seminar last week on inspections, and this was without doubt the best advice we all got. Everyone walked away feeling confident that it was easy as cherry pie, with some really useful tips.The seminars are free, their site is everythingcqc.com

I don't know what to say. Through my experience it is not that something needed for NHS patients. Do something to extend the hospital services and employe more consultants and doctors. All people doing is "saving and saving" but nobody realises that people are dying without effecient medical services due to lack of funding. Without money no primary care service could run their business. Something wrong somewhere. Feeding software companies to do their businesses like QOF, CQC, IG toolkit all technologies. We must fit in with the demanding population. We cannot just cut and cut the budget. New hospitals are needed locally. New GP Practices are needed.

Britain has laboured GPs with so much laws and regulations while pCTs have flouted health & safety regulations without blinking an eye.For pCts are not even answerable to GMC but to their manipulatable inhouse complaints system.Where is britain leading its NHS,its jewel in the crown into